HomeMy WebLinkAbout20180522 Koser Miller.pdf18052201
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KC Wisconsin Motor Vehicle
Crash Report
Secondary
CrashAmendedCrash Type
Private Property/Parking LotReportable
TagsSchool Bus Related
Yes, school bus directly inActive School ZoneGovernment
Property
Trailer or TowedWork ZoneLane ClosureHit and RunOn Emergency
Total Killed
00
Total Injured
00
Total Units
02
Time Notified
08:21 AM
Date Notified
05/22/2018
Time Arrived
08:26 AM
Date Arrived
05/22/2018
Crash Time
08:20 AM
Crash Date
05/22/2018
Investigating Officer/Deputy
DEPUTY AMANDA REED
Agency Crash NumberPrimary Crash Document #Document Number Override
6V
L
1
3
J
5
5
K
C
Additional InformationPhotos
Photos ByDEPUTY AMANDA REED
Reconstruction ByDiagram
Description
Narrative: I, a sworn law enforcement officer, agree that I have not added any CJIS data in this report.
ON MAY 22ND, I, DEPUTY REED RESPONDED TO A BUS VS CAR ACCIDENT AT THE HAYWARD INTERMEDIATE SCHOOL IN THE BUS DROP OFF ZONE ON SCHOOL PROPERTY. THE SCHOOL BUS DRIVER WAS ATTEMPTING TO NEGOTIATE A CORNER AND ACCIDENTLY SIDE SWIPED A VEHICLE THAT
WAS NOT SUPPOSE TO BE PARKED IN THE LOADING UNLOADING ZONE. PHOTOS TAKEN OFF ACCIDENT.
Crash Time 08:20 AM
Crash Date 05/22/2018Wisconsin Motor Vehicle Crash
Form DT4000 1 of 6
This report does not include any CJIS data.
18052201
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KC Wisconsin Motor Vehicle
Crash Report
Structure Type
House/Building
Y Coordinate
5105525.5
X Coordinate
152377.578125
Longitude
-91.490744899
Latitude
46.014996368
PRIVATE PROPERTY
15930 FIFTH ST
(HOUSE/BUILDING 15930)
IN THE CITY OF HAYWARDIN SAWYER COUNTY
Location
Special StudyAccess Control
No Control
Tribal Land
Crash Classification - Jurisdiction
Private Property
Crash Classification - Location
Private Property
Relation To Trafficway
Non Trafficway - Other
Animal Type
Weather Condition(s)
Environment Factor(s)
None
Roadway Factor(s)
None
Road Surface Condition(s)
Dry
Light Condition
Daylight
Manner of Collision
05--Sideswipe/Same Direction
First Harmful Event Location
In Parking Lane or Zone
First Harmful Event
Motor Veh In Transport
Crash Scene
Intersection Type
Not an Intersection
Junction Location
Non-Junction
Within Interchange Area
NO
Reporting Threshold
No
Truck Bus or HazMat
Any vehicle designed to carry 9 or more ppl, including driver
Road Grade
Level
Road Curvature
Curve Left
Surface Type
Blacktop (Bituminous)
Traffic Control Inoperative/Missing
NO
Traffic Control
No Control
Traffic Way
Parking Lot or Private Property
Emergency Motor Vehicle UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With
Parked Motor Vehicle
Total Lanes
0
Speed Limit
15Pre CrashTire
Mark
Direction Of Travel
Not On Roadway
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # Injured
0
Total Occs
1
Operating As Endorsements
S - SCHOOL BUS
Vehicle Type
School Bus
Unit Type
Bus
Vehicle Operating As Classification
C CLASS
Unit Status
In Transit
UN
I
T
01
Unit Summary
Extent Of Damage
Minor Damage
Vehicle Damage
5--Right Rear Corner
Initial Contact Point
5--Right Rear Corner
Bus UseSchoolBody Style
BU - BUS
Color
YEL - Yellow
Model
1 DOOR BUS
Year
2007
Make
I C CORPORATION
Vehicle Identification Number
14
Country of Issuance
UNITED STATES
St
WI
Plate Type
BUS - Bus
License Plate Number
3256B
VE
H
I
C
L
E
UN
I
T
01
Vehicle
Crash Time 08:20 AM
Crash Date 05/22/2018Wisconsin Motor Vehicle Crash
Form DT4000 2 of 6
This report does not include any CJIS data.
18052201
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KC Wisconsin Motor Vehicle
Crash Report
Driver DistractionsNot Distracted
Driver Actions
Other Contributing Action
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Negotiating Curve
Vehicle Removed By
OPERATOR
Towed Due To Damage
Not Towed
VE
H
I
C
L
E
UN
I
T
01
Address
HAYWARD, WI 54843 , US
Organization/CompanyHURRICANE BUSING INC01
VE
H
I
C
L
E
OW
N
E
R
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
EventParked Motor Vehicle02
Event
03
Event
04
Organization/Company
HURRICANE BUSING INC
Insurance Company
PEERLESS-INS-CO
Policy Holder
UN
I
T
Crash Time 08:20 AM
Crash Date 05/22/2018Wisconsin Motor Vehicle Crash
Form DT4000 3 of 6
This report does not include any CJIS data.
18052201
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KC Wisconsin Motor Vehicle
Crash Report
Individual Condition
Appeared Normal
Drug Type
Drug Test ResultsDrug Test TypeDrug Test GivenTest Not Given
Alcohol Test ResultsAlcohol Test TypeAlcohol Test Given
Test Not Given
Suspected Drug UseSuspected Alcohol Use
Action Other
IN
D
I
V
I
D
U
A
L
UN
I
T
Action
To/From SchoolLocationPrior ActionStriking Unit #
00
1
01
Time of DeathDate of DeathHospital
EMS Run #EMS Agency IdentifierMedical Transport
Not Transported
Trapped/Extricated
Not Trapped
Ejection Path
Not Ejected/Not Applicable
Ejected
Not Ejected
Airbag
Non Deployed
Injury Severity
No Apparent Injury
IN
D
I
V
I
D
U
A
L
UN
I
T
Tint ComplianceEye Protection
Helmet ComplianceHelmet Use
Seat Position
1--Front Seat-Left Side (Driver/Motorcycle/Bicycl
00
1
Safety Equipment
Shoulder & Lap Belt
On Duty Crash
01
State: Wisconsin Country: UNITED STATES
Address
HAYWARD, WI 54843 , US
RaceWHITEDate of Birth
11/19/
Sex
Male
Citations Issued
0
DriverDON P KOSER
IN
D
I
V
I
D
U
A
L
UN
I
T
Injury
Drug &
Alcohol
Individual
Non Motorist
Equipment
Address10293 N GREENWOOD LANE
HAYWARD, WI 54843 , US
NameHURRICANE BUSING INC
Source
DriverUse Vehicle Owner Same as Carrier
01
Carrier
Crash Time 08:20 AM
Crash Date 05/22/2018Wisconsin Motor Vehicle Crash
Form DT4000 4 of 6
This report does not include any CJIS data.
18052201
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KC Wisconsin Motor Vehicle
Crash Report
Measured WeightMeasured WidthMeasured LengthMeasured Height
Escort Vehicle PresentEscort Vehicle Required
By Permit
Permitted Vehicle On
Permitted Route
WI Permit NumberOS/OW Load
Permitted LoadCarrier TypeUS DOT #
Cargo Body TypeVehicle Configuration GVWR
TR
U
C
K
B
U
S
UN
I
T
Reporting Threshold
No
Truck Bus or HazMat
No
Road Grade
Level
Road Curvature
Curve Left
Surface Type
Blacktop (Bituminous)
Traffic Control Inoperative/Missing
NO
Traffic Control
No Control
Traffic Way
Parking Lot or Private Property
Emergency Motor Vehicle UseNot ApplicableSpecial FunctionNo Special FunctionMost Harmful Event: Collision With
Motor Veh In Transport
Total Lanes
0
Speed Limit
15Pre CrashTire
Mark
Direction Of Travel
Not On Roadway
Insurance?
YES
Total HazMat Types
0
Total Trailers
0
Total # Citations Issued
0
Train/Bus # InjuredTotal Occs
0
Operating As EndorsementsVehicle Type
Passenger Car
Unit Type
Automobile
Vehicle Operating As Classification
D CLASS
Unit Status
Legally Parked
UN
I
T
02
Unit Summary
Driver Distractions
Driver Actions
No Contributing Action
Driver Prior Action Other
Vehicle Factors
Not Applicable
What Driver Was Doing
Legally Parked
Vehicle Removed By
OWNER
Towed Due To Damage
Not Towed
VE
H
I
C
L
E
UN
I
T
02
Extent Of Damage
Functional Damage
Vehicle Damage
9--Left Side Middle
Initial Contact Point
9--Left Side Middle
Bus UseNot A BusBody Style
4D - 4DR
Color
GRY - Gray
Model
6
Year
2008
Make
MAZDA
Vehicle Identification Number
1 5951
Country of Issuance
UNITED STATES
St
WI
Plate Type
AUT - Automobile
License Plate Number
ACN6610
VE
H
I
C
L
E
UN
I
T
02
Vehicle
Crash Time 08:20 AM
Crash Date 05/22/2018Wisconsin Motor Vehicle Crash
Form DT4000 5 of 6
This report does not include any CJIS data.
18052201
SAWYER COUNTY SHERIFFS DEPT
15880 EAST FIFTH STREET
HAYWARD, WI 54843
(715) 634-4858
6VL13J55KC Wisconsin Motor Vehicle
Crash Report
Not Distracted
Address
HAYWARD, WI 54843 , US
IndividualREANNA M MILLER
(
Vehicle Owner
Sequence Of Events
EventMotor Veh In Transport01
EventParked Motor Vehicle02
Event
03
Event
04
Individual
REANNA MILLER
Insurance Company
GEICO-GENERAL-INS-CO
Policy Holder
UN
I
T
Crash Time 08:20 AM
Crash Date 05/22/2018Wisconsin Motor Vehicle Crash
Form DT4000 6 of 6
This report does not include any CJIS data.